Pregabalin as adjunctive therapy in benzodiazepine discontinuation.

PURPOSE: The available evidence for the use of pregabalin as adjunctive therapy in the discontinuation of benzodiazepines is reviewed. SUMMARY: Pregabalin has been studied as an adjunctive pharmacologic treatment for the discontinuation of long-term benzodiazepine use. Unlike carbamazepine, pregabalin has little potential for drug interactions, and its adverse effects are mostly mild and transient. Pregabalin reduces the release of excitatory neurotransmitters by binding to regulatory subunits of voltage-activated calcium channels. The majority of studies evaluated failed to find a significant difference in benzodiazepine discontinuation rates between pregabalin and comparator groups. The long-term efficacy of pregabalin in benzodiazepine discontinuation is also unknown, as patients were only followed for 0-12 weeks after discontinuing the benzodiazepines. Most studies, however, did observe consistent improvement in withdrawal symptoms, anxiety symptoms, and cognitive function with pregabalin use in benzodiazepine discontinuation. Studies varied in design elements, such as whether past benzodiazepine discontinuation attempts occurred, baseline benzodiazepine use characteristics (agent, dose, duration), benzodiazepine discontinuation strategies previously used, and the use of comorbid psychiatric diagnoses and concurrent psychotropics as exclusion criteria. In addition, the literature does not clearly describe whether patients successfully discontinued pregabalin, for which there are reports of substance abuse. CONCLUSION: Based on the current available evidence, pregabalin is not recommended for use in benzodiazepine discontinuation, as the majority of studies did not find a significant difference in benzodiazepine discontinuation rates between pregabalin and comparatory groups despite an improvement in withdrawal and anxiety symptoms.

Review of Community Based Organization and Community Pharmacy Partnerships for Preventive Care Services.

Collaborative care has been widely recognized as being critical to promoting the health of individuals and populations. It is hypothesized that the development of partnerships between community-based organizations and community pharmacies may result in increased access to preventive care services for community members with the goal of improving health outcomes. The purpose of this review was to identify and describe partnerships between community-based organizations and community pharmacies. A literature search was conducted for all articles in the English language published through January 2018 that included these types of partnerships offering preventive care services. A total of seven articles were included in the review, of which the majority were conducted in the United States (n=5). Community-based organizations included businesses, community health centers, local associations, public health departments, schools, and workplaces. Preventive care services that were offered included blood pressure and cardiovascular risk assessment, diabetes management, flu ready card and HIV self-test kit voucher distribution and education, and bone mineral density screenings. The limited literature suggests that additional opportunities should be explored in order for community-based organizations and community pharmacies to partner in order to provide and evaluate the impact of preventive care services in the community setting.